Perhaps the most controversial aspect of attention and hyperactivity problems in children is the role of the physical environment. This includes what the child eats (sugar, other foods, food additives, chemicals), exposure to airborne pollution, and light and sound stimuli. Does the physical environment have an important influence on the attention capacities of children, and are some children more sensitive than others? Before getting into specifics, let me share some general principles related to the controversies.
When there are competing or controversial results from studies looking at an issue as simple as whether sugar has an effect on attention, we have to consider the problem of subgroups. In other words, when you look at a large population or even a smaller group of thirty or forty children, you're usually mixing children with different profiles. They may share a common problem like inattentiveness or a high activity level, but may have different sensitivities. For example, one group of children may have a low threshold for excitement, and a little bit of extra adrenaline in their systems might cause them to be quite inattentive and active. But then there might be another group of children with a high threshold for excitement and containment, and the sugar might just give them a pleasant boost of energy that they enjoy and that actually helps them focus and attend even better. Similarly, a couple of cups of coffee will cause some adults to be jittery, while for others it just gets their day going. Careers For People With ADD
They may feel more organized and focused and more competent in what they do. It's the same with wine - two or three glasses of a fine red wine with dinner makes some people nice and relaxed and social, while it may get others a little tipsy to the point of stumbling or slurring their words, or they may become argumentative because they are very sensitive to the effects of alcohol. For still others, it may have no effect at all until they have their fifth drink.
There are also a lot of individual differences in the way people respond to different environmental factors. That is because everybody's nervous system is different. When the research looks inconsistent, it is often because we haven't considered the possible subgroups. Often, we haven't looked at subgroups because we haven't really known how to categorize them.
As we've shown in earlier posts, we can divide groups of children based on their underlying ability to plan and sequence, to modulate sensations, to comprehend what they hear or see. We can look at children with one of these different profiles and see how they respond to elements in their physical environment. If we are going to resolve some of the controversies, as a general principle we need research that looks at subgroups in clinically meaningful ways, based on children's developmental profiles and patterns. If research studies treat all children who meet criteria for a certain problem on some questionnaire or some observational scale or test in the same way, we won't know what the results of these studies mean. Unfortunately, we are still in the Dark Ages when it comes to many of these questions.
First Steps Be a Good Detective
Start off by investigating, looking for patterns. After a birthday party, for example, where your child has eaten all kinds of sweets and sugary things, how does she behave? When your child is in a very stimulating environment with a lot of noise and visual stimulation, how does she behave? When she is in a very dull, low-key environment with not much going on, how does she behave? This is your first step and will give you clues to things you may want to investigate more closely.
Get a Thorough Physical Examination. As part of a good pediatric evaluation, have the child's thyroid functioning (hypothyroidism can produce low energy and inattentiveness, and hyperthyroidism can produce a lot of activity and distractibility). Anemia can cause low energy levels, along with sluggishness and inattentiveness. A recent pediatric examination is very important to rule out any physical basis for the child's problems that can be corrected through proper medical treatment and management. Careers For People With ADD
As part of the general pediatric evaluation it is also very important to rule out things like blood levels of lead and other toxic metals. These can be injurious to the child's overall health, affect attention and the way the child focuses, as well as affect the way the child is able to maintain a state of calm regulation, even in the face of a lot of stimulation.
Overall Nutritional Status. Next, look at the child's overall nutritional status. Does he have a reasonably healthy diet with a balance of proteins, fats, and carbohydrates, and plenty of vegetables and fruits? Many children don't have this type of balanced diet. Is the child getting proper vitamins and minerals in his diet or through supplements? A child who is not eating a balanced diet or isn't getting the proper vitamins and minerals can be subject to physiological challenges that will certainly contribute to behavior. To learn more about ADHD, you must check out Careers For People With ADD.
